RESUMEN
INTRODUCTION: Carbamazepine (CBZ) is a pharmacological agent used to control epileptic syndromes. In refractory epilepsy patients, however, a second anticonvulsive drug such as lamotrigine (LTG) is often added. This association can reduce the frequency of the epileptic seizures and favour control over them. AIMS: This study was conducted to evaluate the plasma concentration of CBZ throughout a period of mono and polytherapy. Furthermore, tests were also carried out to determine whether any alterations were caused in the haematological parameters or in plasma concentrations by adding LTG to the therapy with CBZ. PATIENTS AND METHODS: This study involved a sample of refractory epilepsy patients who were following monotherapy with CBZ and who had a wholly unsatisfactory control over their bouts of seizures. LTG was thus added to these patients' treatment in an attempt to improve their control over the seizures. RESULTS AND CONCLUSIONS: On ending the study, we found that LTG did not interfere with the plasma concentrations of CBZ or give rise to any kind of alteration in the haematological parameters of any of the patients. Nevertheless, one patient did break out in a rash, which shows that therapeutic monitoring may be a key tool, especially when the treatment that is prescribed includes two drugs with a narrow therapeutic range.
Asunto(s)
Anticonvulsivantes/uso terapéutico , Carbamazepina/uso terapéutico , Interacciones Farmacológicas , Epilepsia/tratamiento farmacológico , Triazinas/uso terapéutico , Adolescente , Adulto , Anticonvulsivantes/sangre , Carbamazepina/sangre , Relación Dosis-Respuesta a Droga , Epilepsia/sangre , Humanos , Lamotrigina , Persona de Mediana Edad , Triazinas/sangreRESUMEN
Introducción. La carbamacepina (CBZ) es un fármacoseleccionado para controlar los síndromes epilépticos. Sin embargo,en pacientes epilépticos refractarios es común la adición de unsegundo anticonvulsionante como la lamotrigina (LTG). Esa asociaciónpuede reducir la frecuencia y favorecer el control de lascrisis epilépticas. Objetivos. Este estudio evaluó la concentraciónplasmática de CBZ durante el período de monoterapia y politerapia.Además, se evaluó también si la LTG provocaba alteracionesen los parámetros hematológicos o en las concentraciones plasmáticasal introducirlo en el tratamiento con la CBZ. Pacientes ymétodos. Para realizar este estudio, se seleccionó a pacientes epilépticosrefractarios que seguían monoterapia con CBZ y poseíanun control nada satisfactorio de las crisis convulsivas. De esa manera,se introdujo en el tratamiento de esos pacientes la LTG paraintentar mejorar el control de las crisis convulsivas. Resultados yconclusión. Al acabar el estudio, constatamos que la LTG no interfirióen las concentraciones plasmáticas de la CBZ, y tampoco provocóalteraciones en los parámetros hematológicos de ningún paciente.Sin embargo, un paciente presentó sarpullido, lo que demuestraque la monitorización terapéutica puede ser una herramientaindispensable, especialmente cuando el tratamiento prescritoincluye dos fármacos con un estrecho intervalo terapéutico
Introduction. Carbamazepine (CBZ) is a pharmacological agent used to control epileptic syndromes. In refractoryepilepsy patients, however, a second anticonvulsive drug such as lamotrigine (LTG) is often added. This association canreduce the frequency of the epileptic seizures and favour control over them. Aims. This study was conducted to evaluate theplasma concentration of CBZ throughout a period of mono and polytherapy. Furthermore, tests were also carried out todetermine whether any alterations were caused in the haematological parameters or in plasma concentrations by adding LTGto the therapy with CBZ. Patients and methods. This study involved a sample of refractory epilepsy patients who werefollowing monotherapy with CBZ and who had a wholly unsatisfactory control over their bouts of seizures. LTG was thusadded to these patients treatment in an attempt to improve their control over the seizures. Results and conclusions. On endingthe study, we found that LTG did not interfere with the plasma concentrations of CBZ or give rise to any kind of alteration inthe haematological parameters of any of the patients. Nevertheless, one patient did break out in a rash, which shows thattherapeutic monitoring may be a key tool, especially when the treatment that is prescribed includes two drugs with a narrowtherapeutic range